Free Patient Feedback Software

Get the feedback you need to provide better care for your patients. Create custom online feedback forms to gather responses securely on any device with Jotform’s free patient feedback software. Protect your data with HIPAA compliance.


Free Patient Feedback Form Templates

Not sure where to start? Select a patient feedback form or survey template below and customize it with our drag-and-drop builder.

Patient Feedback Form


Medical Questionnaire


COVID-19 Vaccine Survey



Instantly Create Feedback Forms

Create Online Surveys

Make your own healthcare surveys with Jotform’s powerful feedback software. Add your logo, customize questions, and personalize other design elements with our intuitive no-code Form Builder.

Receive Notifications Instantly

View feedback instantly with email notifications. You can also download Jotform Mobile Forms — our free mobile app — to receive push notifications on your iOS or Android device.

Expertly Manage Submissions

Manage form submissions in Jotform Tables as a spreadsheet or as individual cards for every patient — or quickly respond to patients’ feedback directly from Jotform Inbox.

Set Up Kiosk Mode

Collect multiple submissions with an in-person kiosk. You can also generate and share a contactless QR code so patients can fill out your form safely from their own device.

Analyze Data Reports

Generate reports with Jotform Report Builder to reveal important insights about your patients. By analyzing feedback, you can discover what your patients like about your services and what needs improvement.


What our users say about Jotform

This is the best tool ever!!! When we were looking for a solution for online registrations, options that we saw involved spending thousands of dollars with no easy customization - it involved paying developers for their time! With Jotform, you can make changes yourself and don't need a whole lot of experience in developing or coding! Love it and will probably continue using it for many years to come!

Alissa Kline, Council Assistant, KLMCarpenters